Methodist Manor Health Center, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

8439 Issued in WI

Legal business name

METHODIST MANOR HEALTH CENTER, INC.

Doing business as

Manor Pharmacy - Trinity

Practice address

7300 W Dean Rd
Milwaukee, WI 53223-2637

Phone

(414) 371-7381

Fax

(414) 371-7525

NPI assigned

Mar 1, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. James Enlund

Title

President & Ceo

Phone

(414) 607-4100

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Manor Pharmacy - Trinity Doing business as

Tax ID family

Manor Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Methodist Manor Health Center Inc

  • Skilled Nursing Facility
  • West Allis, WI
  • NPI 1134196983
  NPD tax ID
• Methodist Manor Health Center Inc.

  dba Olsen Medical Clinic - Trinity

  • Health Service Clinic/Center
  • Milwaukee, WI
  • NPI 1235106576
  NPD tax ID
• Methodist Manor Health Center, Inc.

  dba Manor Pharmacy

  • Pharmacy
  • West Allis, WI
  • NPI 1073580403
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1518934264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100",
            "fax_number": "414-607-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W DEAN RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232637",
            "telephone_number": "414-371-7381",
            "fax_number": "414-371-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANOR HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ENLUND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "414-607-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "8439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33279600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "8439",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "5128120",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manor Pharmacy - Trinity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.